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Critical Care

June 4, 2016
The authors analyzed long-term outcomes after cardiac surgery in nearly 10,000 patients to evaluate the mortality risk of blood transfusion.  Sex-mismatched transfusion increased mortality, and use of non-leukocyte-depleted blood was associated with increased mortality.  The age of the blood productes was not related to mortality.
May 5, 2016
The author summarizes the challenges but tremendous potential of mechanical circulatory support for infants and children undergoing heart surgery.
March 27, 2016
Norepinephrine is often used to maintain the mean pressure during open heart surgery but it is said that it could constrict cerebral arteries, reducing cerebral blood flow. Is it true? The authors explored the association of Norepi doses and rSO2 measured using near-infrared spectroscopy.
March 14, 2016
Early hepatic dysfunction has previously been reported to be an independent risk factor for poor prognosis in critical ill patients. Hepatic and bowel ischemic complication are unfortunately common in patients that require venoarterial (VA) ECMO therapy following a cardiac surgery procedure.
March 7, 2016
This is a very interesting and provocative article that discusses Exracorporeal Cardiac Life Support (ECLS) as an adjunct to CPR. ECLS has gained in popularity with new tools and techniques, ECLS guidelines, protocols and better understanding of the importance of early initiation.
March 4, 2016
Lactic acidosis is a very common biological issue for the postoperative patient with shock. This very nice review addresses thehemodynamic consequences of shock-associated lactic acidosis and highlights the various therapeutic options that can be considered by the bedside clinician.
March 4, 2016
The optimal timing of tracheotomy in critically ill patients remains a topic of debate. The Authors performed a systematic review to clarify the potential benefits of early versus late tracheotomy. Three categories of timing of tracheotomy (within 4 versus after 10 days, within 4 versus after 5 days, within 10 versus after 10 days) were analyzed.
February 23, 2016
This consensus effort provides a new definition for septic shock, which affects a subset of patients with sepsis.   The definition requires the presence of circulatory disturbances (BP unresponsive to fluids and requiring pressors), cellular and metabolic abnormalities (serum lactate level >2 mmol/L).  The presence of these criteria is associated
February 18, 2016
The authors studied the relationship of outcomes after non-cardiac surgery to blood transfusion among over 7,300 patients.   Patients with significant bleeding were excluded.  Patients were stratified according to the occurence of postoperative MI and the nadir hematocrit value (20-24%, 24-27%, 27-30%).  The outcome was 30-day mortality.   In the no-
January 30, 2016
Outcomes of CABG for patients in cardiogenic shock after acute MI were evaluated using data from the STS Database.  The study group of nearly 5,500 patients comprised 1.5% of all CABG patients during the study period.  Operative mortality was 18.7%.  Mechanical circulatory support use was most common in patients with more risk factors or high clinica

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